Venous thromboembolism in pregnancy – symptoms, prevention

Venous thromboembolism – what is it?

Venous thromboembolism includes deep vein thrombosis and pulmonary embolism. In its course, thrombus formation occurs, which closes the lumen of the vessels. The detachment of the thrombus, which enters from the lower extremities through the venous circulation to the heart and then the pulmonary circulation, can lead to closure of the pulmonary artery and pulmonary embolism. The timing of pregnancy, due to, among other things. The increase in the concentration of circulating estrogen in the bloodstream is a period of increased risk of venous thromboembolism. For this reason, appropriate prophylaxis should be implemented in women with a burden or high risk of developing this disease.

Venous thromboembolism – risk factors in pregnancy

Pregnant women and postpartum women are at risk of developing venous thromboembolism. There is a higher risk in obese patients when the BMI exceeds 35, and those with a family history of thrombotic or pulmonary embolism episodes. The risk also increases if you are in a reclining position for a long time or have undergone surgery during pregnancy. Women struggling with thrombophilia or antiphospholipid syndrome are also included in the risk group.

Venous thromboembolism – prevention in pregnancy

When risk factors are present, appropriate prevention is implemented. Currently, a lot of attention is paid to ensure that the mother-to-be does not spend most of the day lying down. There is also a revival of the so-called. bed regime. This is because it has no proven efficacy for, for example, threatened preterm labor, and significantly increases the risk of thromboembolic disease.

Compression stockings and heparins are used in the prevention of lower extremity thrombosis. Low molecular weight heparins are used during pregnancy. A gynecologist in the first trimester assesses the risk of venous thromboembolism and the possible appropriateness of using compression stockings and heparin. This risk can be modified during pregnancy depending on the risk factors present. Heparins are used, among other things. In pregnant women after surgeries or operations.

Postpartum reassessment of thromboembolic disease risk is indicated. More often, heparin prophylaxis is given to patients after delivery by cesarean section or in cases of perinatal hemorrhage, for example. Some women should use heparins throughout the postpartum period.

Venous thromboembolism in pregnancy – symptoms

The first symptom of venous thromboembolism can be lower extremity thrombosis. It is usually manifested by pain in the calf when walking and swelling of the limb. When pulmonary embolism occurs, symptoms such as shortness of breath, chest pain and coughing appear. Hemoptysis may also occur. It should be remembered that there are cases when the symptoms of thrombosis are not present, and pulmonary embolism develops anyway. For this reason, if a pregnant woman develops sudden dyspnea, an urgent visit to a gynecological and obstetric hospital is necessary.